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Hypothyroidism rarely contributes to the need for prolonged mechanical ventilation in patients with lung disease
The background of the study. Patients with hypothyroidism
may have breathing problems as a result of narrowing of their airways,
weakness of respiratory muscles, or poor ventilation of their lungs.
Hypothyroidism could, therefore, contribute to the need for mechanical
ventilation in patients with severe lung disease. In this study,
the frequency of hypothyroidism was determined in patients with
respiratory failure.
How the study was done. In 140 patients with respiratory failure (mean age, 66 years) treated with mechanical ventilation, serum thyrotropin (TSH) was measured at the time of admission to a center for weaning from the ventilating machine. All had required mechanical ventilation for at least three weeks. The respiratory failure was caused by chronic lung disease, cardiovascular surgery, noncardiovascular surgery, pneumonia, or neuromuscular disease.
The results of the study. The patients’ serum TSH concentrations ranged from 0.19 to 121.0 mU/L; 17 patients (12 percent) had high values, suggesting hypothyroidism. Four patients (3 percent) were given a new diagnosis of hypothyroidism and were treated. In the remainder, the high serum TSH concentrations were attributed to an improved clinical status at the time of transfer to the weaning center. Ninety-two of the 140 patients (66 percent) were successfully weaned from mechanical ventilation, including 13 of the 17 patients with high serum TSH concentrations (76 percent).
The conclusions of the study. Few patients requiring prolonged mechanical ventilation have hypothyroidism, but when it is present appropriate therapy may facilitate weaning from the ventilator.
The original article. Datta D, Scalise P. Hypothyroidism
and failure to wean in patients receiving prolonged mechanical ventilation
at a regional weaning center. Chest 2004;126:1307-12.
Next Article: Lean body mass is
the major determinant of thyroxine dose in patients with hypothyroidism |
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